More than 12 years after a car accident left him in a vegetative state, a Canadian man has begun communicating with doctors who are monitoring his brain activity through Functional Magnetic Resonance Imaging (fMRI) scans.

The BBC reports that 39-year-old Scott Routley has been able to communicate to doctors that he is not in any pain, marking the first time an uncommunicative, severely brain-damaged patient has been able to give direct answers regarding their care and treatment.

"Scott has been able to show he has a conscious, thinking mind," British neuroscientist Adrian Owen told the BBC. "We have scanned him several times and his pattern of brain activity shows he is clearly choosing to answer our questions. We believe he knows who and where he is."

Owen leads a team at the Brain and Mind Institute, University of Western Ontario, which used MRI scans to measure responses from Routley.

Traditional tests have continued to indicate that Routley is in a vegetative state, with no relevant brain activity. Owen and other doctors say this means medical text books will literally need to be re-written when it comes to evaluating patients suffering from severe brain injuries.

Routley's previous neurologist said that for a decade all test results taken from scans of Routley's brain indicated he was not experiencing any mental activity.

"I was impressed and amazed that he was able to show these cognitive responses, said University Hospital's Bryan Young. "He had the clinical picture of a typical vegetative patient and showed no spontaneous movements that looked meaningful."

Owen says the results could lead to improved patient care for those living with severe brain injuries, making a major improvement in the daily of patients, including routine tasks such as when they prefer to be fed or bathed.

A former classmate of mine made the decision to pull his wife off life support, just last night.

She had been brain dead for 5 days; and, apparently the doctors use 5 days as a measuring stick. They told him ‘it was time to make some decisions’.

He obviously loved her very much - he poured his heart out for 5 days on a blog like site called Caring Bridge. His wife’s mother and sister were there, when they ‘pulled the plug’, so I think they were in agreement.

I was astonished that 5 days seemd to be the limit...the point at which the doctors started pressuring him to remove her from the machines. But, I have no medical expertise whatsoever, and I assume the doctors know when there is ‘no chance’.

Then this article comes along...and I don’t know what to think.

14
posted on 11/14/2012 6:52:27 AM PST
by lacrew
(Mr. Soetoro, we regret to inform you that your race card is over the credit limit.)

Try 30 seconds, and the brain still functioning. My Dad went on a ventilator, and within 30 seconds a little RAT-FACED Dr with a foreign accent was telling me to pull the plug.

Dad was still awake, and able to communicate by squeezing our hands. Once for yes. Twice for no. I told rat face that he was not God, and he couldn’t possibly know how things would turn out. I demanded that the antibiotics be given time to work.

Death panels have been here for a while already.

16
posted on 11/14/2012 7:00:56 AM PST
by greeneyes
(Moderation in defense of your country is NO virtue. Let Freedom Ring.)

In all reality doctors know very little about the brain. Medical tests are not reliable either, people showing severe effects of brain damage can have normal looking scans, and people with little effects can have scans that show a lot of damage.

It really is a world of mystery, and yet some doctors are willing to make huge decisions based on something they really don’t know about. It makes it very hard for family to make a decision as to care, though many families don’t know how little is really known about the brain.

There is a lot of research being done right now by the military and doctors working with the military because we have many who have suffered traumatic brain injury (TBI) in Iraq and Afghanistan.

22
posted on 11/14/2012 7:17:56 AM PST
by Tammy8
(~Secure the border and deport all illegals- do it now! ~ Support our Troops!~)

I don't want to be wet blanket here, but here is the nagging doubt I have about this story:

Is the doctor running the "communication test" the ONLY person that can "Interpret" the patient's responses? If so, then this is no better than the "guided writing" and other supposed methods of reaching brain damaged people.

It just turns out that the person "interpreting" the results is simply the one supplying the answers.

I think that what doctors want people to assume. In reality, they have no more definitive answer than the rest of us as to whether or when people will recover from these traumatic brain injuries. They may have a general sense of the probabilities, but there is no way for them to accurately judge any specific case.

I don't have rows with anyone about whether I donate my body. I refuse to do it. Until they pay my family for the organs. I mean it. While hospitals, doctors, nurses, anesthetists, etc. all get paid for using my organs why should my family not get a cut?

Note to anyone wanting to point out my selfishness. Don't bother. I was a donor till I read stories about how much is costs the insurance companies to cover these operations. Someone gets that money why shouldn't my family get some of it?

30
posted on 11/14/2012 8:05:40 AM PST
by raybbr
(People who still support Obama are either a Marxist or a moron.)

My problem is I don't have too many bad habits, I don't have any chronic ilnesses and I'm in top shape for my age. The people who take me to task know me too well. (But I should have used it on the libtard bimbo at the DMV. She registered me in as a donor against my wishes (and absent he consent form!). I made her back out my records and re-generate my license, which made her very unhappy.)

Maybe I should start drinking heavily. God knows I'd like to these days.

This process can remove all doubt as to sentience of the “vegetative” one vs’s no personality response at all. It will make it easier to make decisions such as “pull the plug”...though in a lot of cases, folks who have “weathered” the initial storm or needing vent support are often vent weaned to just trach/collar O2 support with suctioning as needed with the patient breathing on his/her own but still in a coma/ semi comatose state. (many times a trach isn’t even needed as some patients have enough autonomic ability to cough and swallow with little air way management needed though they’ll still be Gastric tube fed)

35
posted on 11/14/2012 8:22:06 AM PST
by mdmathis6
("Barry" Xmas to all and have a rapaciously taxable New Year!)

Why didn’t we think of this sooner! It is sooo simple: Ask qwuestions and have the aptient answer by thinking in various terms, such as a math equation for yes and colors for no. The brain activity changes based on the patients thoughts. Then ask known questions: Is your name Routley? Is your name Mary? Do you know that you are in a hospital? Do you think you are in a zoo? etc.

37
posted on 11/14/2012 8:31:11 AM PST
by CodeToad
(Padme: "So this is how liberty dies... with thunderous applause.")

There must be some discernible boolean state they can read (and he can positively control). They ask him yes or no questions that he and they know the answers to (do birds fly? is the sky green?) to verify the communication. Then they can ask him other questions: “Do you want to continue to live?” “Do you like the massages the night nurse gives?”

In this woman’s case, she collapsed suddenly, and CPR was administered to her for 40 minutes, before she regained a pulse.

Then she was taken to the ICU. I have no idea what machines were hooked up to her; but, she did not exhibit brain activity for 5 days. I don’t know if she needed a ventilator; but, I think she probably did, if there was no brain function.

And the brain function was what the discussion was about. Once they took her off whatever machine she was on, she died within minutes...so this wasn’t a case of a body able to breath without medical help, but only in need of somebody kind enough to ‘feed’ them.

I understand that doctors have to be blunt with patients and their families...and from the minute I heard about this 5 days ago, I was very worried that 40 minutes of cpr would be very bad for her brain...so I don’t doubt the doctors’ assessment that she was ‘brain dead’.

I am still astonished that 5 days seems to be the threshold they use. And I was amazed that it all happened in one day yesterday. In the early afternoon they had the discussion with the doctor about pulling the machines off...and at 6:30 pm, they did the deed. I would have pleaded for ‘just one more day’ after having the initial discussion.

Anyway, I hope my old classmate steers clear of this article, or he’ll have second thoughts for the rest of his life (or even more than he’ll already have).

43
posted on 11/14/2012 9:44:06 AM PST
by lacrew
(Mr. Soetoro, we regret to inform you that your race card is over the credit limit.)

While I get your point, the text you cite is not that reassuring to me.

"...each produces a distinct pattern of activity, in the premotor cortex for the first task and the parahippocampal gyrus for the second... It allowed the researchers to put a series of yes or no questions to severely brain-injured patients..."

Look, I don't give a damn' what you think about Obama-Care - but try having a modicum of respect for those of us who've had to deal with this issue in real life. There's no call for "Vega Table folks." That's disgusting and disrespectful.

Since we haven't seen the real data from the experiment, we can't really say. Maybe the difference between the two patterns is as persuasive as having a traffic light rigged up to the patient's brain. If the doctors publish their exact protocol in a peer-reviewed journal, other scientists and doctors will have an opportunity to propose alternate explanations for the data, if any are possible.

You could say that one weak hand squeeze is meaningful and another is just an involuntary reflex. Same for blinking.

A former classmate of mine made the decision to pull his wife off life support, just last night. She had been brain dead for 5 days

It's an awful, awful decision one has to make and will likely have second doubts about it for the rest of your life. The only thing you can gain comfort from is knowing that another critically ill child or adult and their respective families will be given a second chance at life thru the harvested organs.......

My younger brother, then 38, was critically injured in a car accident back in 1998 while on business in California. He laid in a coma for a week before the decision was made. We were told that approximately 35 people would be the beneficiaries of his death....I just wish they could have know what a wonderful kid he was.

49
posted on 11/14/2012 10:58:42 AM PST
by Hot Tabasco
(Jab her with a harpoon.....)

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